The main questions of the theme

Приложение № 10

S E M E Y S T A T E M E D I C A L U N I V E R C I T Y

METHODICAL GUIDANCE FOR CLASSES

(practical)

Specialty: General medicine

Discipline: Pharmacology-2

Chair: Pharmacology, Pharmacognosy

Course III

Theme № 2 of Musculoskeletal Pharmacology. Drugs affecting bony structure and regulating the metabolism of calcium and phosphorus. Peculiarities of the use in children.

Editor: assistant-professor, candidate of medical sciences ______ S.K.Seilkhanov

Semey – 2009

Ratified at the meeting of the chair

Protocol №

the ___ of ______________________ 2009.

The Head of the chair_____________________M.N.Moussin

1. The theme: Drugs affecting bony structure and regulating the metabolism of calcium and phosphorus. Peculiarities of the use in children.

2. The aim: To introduce to Pharmacology of Drugs affecting bony structure and regulating the metabolism of calcium and phosphorus.

3. The objectives:

You should know:

Drugs affecting bony structure and regulating the metabolism of calcium and phosphorus.

You should be able to:

• List the agents useful in hypercalcemia.

• List the major and minor hormonal regulators of bone mineral homeostasis.

• Describe the major effects of parathyroid hormone on the intestine, the kidney, and bone.

• Describe the major effects of the vitamin D derivatives on the intestine, the kidney, and bone.

• Describe the therapeutic and toxic effects of bisphosphonates.

• Describe the therapeutic and toxic effects of fluoride ion.

The main questions of the theme

1. Describe the processes involved in inflammation

2. List separately the mediators of acute and chronic inflammation.

3. Name different groups of drugs which act as anti-inflammatory.

4. Draw the diagram to illustrate various steps that occur in producing inflammation and bronchospasmdue to disturbance of cell membrane. Also indicate the site of action of anti-inflammatory drugs.

5. Classify non-steroidal anti-inflammatory drugs (NSAIDs). How do they act as anti-inflammatory and analgesic drugs?

6. Describe the pharmacology of saicylates.

7. Describe the main features of the different non-narcotis/analgesic-antipyretic/NSAIDs.

8. Name the various propionic acid derivatives and their formulations and usual anti-inflammatory doses.

9. What are the adverse effects of phenylbutazone?

10. Write notes on Diclofenac, Mefenamic acid, and Piroxicam. What are their advantages and disadvantages?

11. Compare Aspirin and Paracetamol.

12. What are the uses and adverse effect of Indomethacin?

13. Discuss the choice of NSAIDs on the basis of activity, frequency of administration and suitability.

14. What is the aim of therapy in rheumatoid arthritis?

15. Which drugs are useful in arthritic conditions?

16. What is the role of simple analgesics, NSAIDs, and corticosteroids?

17. Discuss the status of gold preparations in rheumatoid arthritis.

18. What is primary and secondary gout?

19. What is the chief abnormality in gout?

20. Is colchicines uricosuric?

21. Describe drugs which are indicated in acute attack of gout.

22. Describe drugs used in chronic gout.

23. Describe the role and mode of action of uric acid synthesis inhibitors.

24. Explain why aspirin and probenecid should not be given simultaneously?

25. How do glucocorticoids act? And what are their metabolic effects on carbohydrate, protein and fat.

26. Describe the pharmacokinetics and routes of administration of corticosteroids.

27. What are the general principles which should be kept in mind regarding the use of corticosteroids?

28. Explain, why abrupt withdrawal of prolonged, high dose corticosteroid therapy is dangerous?

29. Describe the various therapeutic uses of adrenocorticoids and give reasons for their beneficial effect in each condition.

30. How do glucocorticoids act as anti-inflammatory and immunosuppressive agents?

31. Describe the adverse effects observed (i) after abrupt withdrawal and (ii) after prolonged therapy. Also give reasons for producing these adverse effects.

32. What is Cushing’s syndrome? How is its treatment managed?

33. Explain how large doses of adrenocorticosteroids produce (i) osteoporosis, (ii) peptis ulceration (iii) hypertension (iv) glaucoma, (v) myopathy, (vi) behavioral disturbances, (vii) hyperglycemia, (viii) retardation of growth in children.

34. What are the contraindications of adrenocorticosteroids?

35. Give a comparison of relative anti-inflammatory and salt-retaining properties of commonly used glucocorticoids and mineralocorticosteroids. Which among them are not effective on topical application?

36. Write short notes on intraarticular injection of glucocorticoids

5.Write prescriptions for next drugs and note their indications and contraindications (precautions):

1. In low and intermittent doses it may actually increase bone formation without first stimulating bone resorption.

2. Its production in the kidney is stimulated by PTH.

3. Natural hormone taken from salmon that is approved for use in the treatment of postmenopausal osteoporosis.

4. It rapidly corrects hypocalcemia and at least partially reverses the secondary hyperparathyroidism caused by renal failure

5. Recombinant human PTH drugfor the treatment of osteoporosis.

6. A secosteroid produced in the skin from 7-dehydrocholesterol under the influence of ultraviolet irradiation.

7. Plant-derived form of vitamin D.

8. Among the inorganic compounds this salt is preferred because of its high percentage of calcium, ready availability (eg, Tums), low cost, and antacid properties.

9. This nonhormonal drug reduces hydroxyapatite formation and dissolution make them clinically useful, particularly, for the treatment of hypercalcemia associated with malignancy, osteoporosis, and syndromes of ectopic calcification.

10. An enolcarboxamide related to piroxicam that is selective COX₂ inhibitor.

11. An agent that blocks COX irreversibly.

12. Antiparasitic drug that increases the magnitude of delayed hypersensitivity or T cell-mediated immunity.

13. Endogenous protein that is approved for the treatment of chronic granulomatous disease.

14. Immunosuppressive agent with efficacy in human organ transplantation and in the treatment of selected autoimmune disorders.

15. Glucocorticoid with very low mineralocorticoid activity and very high topical activity; used for dermatologic conditions.

16. The most potent glucocorticoid drug for systemic use.

17. Active metabolite of a synthetic glucocorticoid; has an intermediate duration of action and low topical activity.

18. A drug used by aerosol in the treatment of asthma.

6. Cholecalciferol [D3] (vitamin D3, Delta-D)	Oral: 400, 1000 IU tablets
Calcitriol	Oral (Rocaltrol): 0.25, 0.5 g capsules, 1 g/mL solution; Parenteral (Calcijex): 1 g/mL for injection
7. Ergocalciferol [D2] (vitamin D2, Calciferol, Drisdol)	Oral: 50,000 IU capsules; 8000 IU/mL drops Parenteral: 500,000 IU/mL for injection
8.Calcium carbonate [40% calcium] (generic, Tums, Cal-Sup, Os-Cal 500)	Oral: Numerous forms available containing 260–600 mg calcium per unit
3.Calcitonin-Salmon	Nasal spray (Miacalcin): 200 IU/puff Parenteral (Calcimar, Miacalcin, Salmonine): 200 IU/mL for injection
9.Alendronate (Fosamax)	Oral: 5, 10, 35, 40, 70 mg tablets
4.Parathyreoidine	Parenteral: 25-250 mcg/ml Nasal spray: 25-250 mcg/ml
5.Teriparatide	20 mcg subcutaneously once a day into the thigh or abdominal wall by prefilled pen delivery device (pen for 28 days).

6. You should be able:

1. Classify non-steroidal anti-inflammatory drugs (NSAIDs).

2. Name different groups of drugs which act as anti-inflammatory.

3. What are the adverse effects of NSAIDs.

4. Discuss the choice of NSAIDs on the basis of activity, frequency of administration and suitability.

5. Describe the pharmacology of salicylates.

6. List several synthetic glucocorticoids and the differences between these agents and the naturally occurring hormone.

7. Describe the toxic effects of chronic glucocorticoid therapy.

8. Describe the pharmacokinetics and routes of administration of corticosteroids.

9. How do glucocorticoids act as anti-inflammatory and immunosuppressive agents?

10. Describe the adverse effects observed (i) after abrupt withdrawal and (ii) after prolonged therapy. Also give reasons for producing these adverse effects.

11. Give a comparison of relative anti-inflammatory and salt-retaining properties of commonly used glucocorticoids.

12. Identify the major cytokines and other immunomodulating agents and know their clinical applications.

13. Describe the mechanisms of action, clinical uses, and toxicities of glucocorticoids, cyclosporine, azathioprine, and cyclophosphamide in immunopharmacology.

7. Teaching methods – working in pairs, the prescription writing of drugs for concrete situations; training, defining terms, solving problems, answer questions, working out examples (of the slides, of the handbooks and handouts), MCQs.

Literature

1.Katzung B. G., ed. 2003. Basic and Clinical Pharmacology, 9^th ed., Lange Medical Books/McGraw-Hill, Appleton and Lange.PP. 1012-1036.

2.Katzung B.G., Trevor A.J., ed. 1998, Examination & Board Rewiew. 5th ed., Stamford, Connecticut, Appleton & Lange. PP.124-135.

2.Tripathi K.D., ed.1999, Essentials of Medical Pharmacology. 4^th ed., New Delhi, India, Jaypee Brothers. PP.115-147.

3.Sharma V.N., ed.1996 Essentials of Pharmacology. 1th ed., New Delhi, India, CBS Publishers & Distributors. PP.201-209.

8. Assessment -MCQs, ECQs.

Дата добавления: 2015-11-16